Prior Auth Required

58552 - 58554; 58570; 58571; 58572; 58573; 58260; 58262; 58263; 58267; 58270; 58275;

This procedure appears on the selected insurer prior authorization source.

Prior authorizationPrior Auth Required
Procedure / Service58554; 58570; 58571; 58572; 58573; 58260; 58262; 58263; 58267; 58270; 58275;
Procedure / Service Description

Prior Authorization List - Together with CCHP Prior Authorization List 58954; 58956; 58240; 58541; 58542; 58543; 58544; 58548; 58550; 58552; 58553; 58554; 58570; 58571; 58572; 58573; 58260; 58262; 58263; 58267; 58270; 58275; 58280; 58290; 58291; 58292; 58293; 58294; 58285; 58240; 58545; 58545; 58546;

Likely documents
  • Confirm benefit details
  • Submit clinical notes if requested by the plan
Next actions
  • Confirm the current plan policy before submission.
  • Use the insurer authorization workflow for this listed code.